Psychiatric complications in patients with severe acute respiratory syndrome (SARS) during the acute treatment phase: a series of 10 cases

Abstract

In February 2003, Hong Kong was hit by a community-wide outbreak of severe acute respiratory syndrome (SARS). During the period of the outbreak, 10 patients with SARS with psychiatric complications were referred to our Consultation and Liaison Psychiatry Team for assessment and management. We found that both the direct and indirect effects of SARS such as symptom severity, total isolation during treatment and administration of steroid were probable causes of psychiatric complications. In this paper, we report on the nature of their psychiatric problems, challenges to management and psychiatric treatment strategies used during the acute phase.

The 1-Year Impact of Severe Acute Respiratory Syndrome on Pulmonary Function, Exercise Capacity, and Quality of Life in a Cohort of Survivors

“…The results are not surprising as, in addition to the physical impairment, the long period of isolation and extreme uncertainty during the SARS illness had created enormous psychological stress 57 and mood distur-bances. 58 In addition, steroid toxicity, personal vulnerability, and psychosocial stressors might have jointly contributed to the development of psychosis in some patients. 59 Other studies 11-14 on acute lung injury or ARDS survivors unrelated to SARS have reported impaired health status at 1 to 5 years after recovery, whereas pulmonary function abnormalities, especially Dlco, correlated with SF-36 domains.…”

The effects of disease severity, use of corticosteroids and social factors on neuropsychiatric complaints in severe acute respiratory syndrome (SARS) patients at acute and convalescent phases

“…To encourage reply we gave phone call to all patients before sending them questionnaires. One of the questionnaires, the SARS Neuropsychiatric Symptoms Checklist (NPSC), was specifically designed to evaluate the neuropsychiatric complaints after SARS according to our initial experiences [5]. It consisted of 25 items covering six neuropsychiatric domains of interest (see Appendix for questionnaire), namely cognition (Q1-4), mania (Q5-8), depression (Q9-15), anxiety (Q16-18), psychosis (Q19-21) and behavioural symptoms (Q22-25).…”

Long-term psychiatric morbidities among SARS survivors

“…In the immediate aftermath of the SARS epidemic, psychiatric morbidity of individual patients began to emerge. The main problems involved adjustment reactions with increased anxiety levels [4][5][6][7]. Studies showed that 10-35% of SARS survivors reported having features of anxiety, depression or both during the early recovery phase [3,8,9].…”